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Acute complications in the current era of therapeutic cardiac catheterization for congenital heart disease

Published online by Cambridge University Press:  19 August 2008

Benjamin Zeevi ,
Michael Berant ,
Rami Fogelman ,
Bar-Mor Galit  and
Leonard C. Blieden
Benjamin Zeevi*
Affiliation:
Cardiology Institute, Schneider Children's Medical Center of Israel, Petah-Tiqva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Michael Berant
Affiliation:
Cardiology Institute, Schneider Children's Medical Center of Israel, Petah-Tiqva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Rami Fogelman
Affiliation:
Cardiology Institute, Schneider Children's Medical Center of Israel, Petah-Tiqva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Bar-Mor Galit
Affiliation:
Cardiology Institute, Schneider Children's Medical Center of Israel, Petah-Tiqva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Leonard C. Blieden
Affiliation:
Cardiology Institute, Schneider Children's Medical Center of Israel, Petah-Tiqva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
*
Benjamin Zeevi MD, 37 Nordau Street, Hertzelia 46585, Israel. Tel: 972 9 9562905; Fax: 972 9 9564150; E-mail: [email protected]
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Abstract

The acute complications of therapeutic cardiac catheterization for congenital heart disease as performed currently in a small unit were reviewed. In recent years, there has been a significant increase in the number of lesions thought amenable to catheter therapy. Only a few reports, however, have addressed the overall incidence of acute complications of therapeutic cardiac catheterization, all representing the experience of centres performing moderate-to-large numbers of procedures. A retrospective review was performed of 425 therapeutic catheter procedures performed at our institution between May 1993 and November 1997. Acute complications were retrieved from the database. This included all adverse events that were clinically recognized at the time of or within 2 weeks after the procedure and which, to the best of the authors' clinical judgement, were related to the catheterization and not part of the natural history of the child's illness. All patients were observed overnight following the procedure, and stayed in hospital if a complication developed. There were 49 acute complications (11.5%), of which 43 (10.1%) were deemed minor and 6 (1.4%) were considered major. The rate was low in patients with valvar pulmonary stenosis, including three neonates (3/45, 6.7%), for those undergoing angioplasty of native co-arctation (1/15, 6.7%) and pulmonary arteries (2/21, 7.4%); and for coil embolization of systemic to pulmonary collateral arteries (1/16, 6.3%). The rate was high in patients with valvar aortic stenosis, including 12 neonates (9/37, 24.3%), and for angioplasty of re-coarctation (4/23, 21.7%). There were more overall complications in neonates (25.6%) than in older patients (10.1%) (p < 0.01). Two patients died (0.5%), but no patient required emergency surgical intervention. In spite of the introduction of many new therapeutic modalities with greater intrinsic risk, and the fact that patients with more complex lesions and who are more acutely ill are being treated, the overall rate of complications remains relatively low. This probably reflects improvements in pericatheterization medical management, in selection of patients, in procedural techniques, and in the experience of operators.

Keywords

Congenital heart diseasetherapeutic cardiac catheterizationcomplications
Type
Original Articles
Information
Cardiology in the Young , Volume 9 , Issue 3 , May 1999 , pp. 266 - 272
Copyright
Copyright © Cambridge University Press 1999

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References

1.Fellows, KE, Radtke, W, Keane, JF, Lock, JE. Acute complications of catheter therapy for congenital heart disease. Am J Cardiol 1987; 60: 679–683.CrossRefGoogle ScholarPubMed
2.Booth, P, Redington, AN, Shinebourne, EA, Rigby, ML. Early complications of interventional balloon catheterisation in infants and children. Br Heart J 1991; 65: 109–112.CrossRefGoogle ScholarPubMed
3.Burrows, PE, Benson, LN, Williams, WG, Trusler, GA, Coles, J, Smallhorn, JF, Freedom, RM. Iliofemoral arterial complications of balloon angioplasty for systemic obstructions in infants and children. Circulation 1990; 82: 1697–1704.CrossRefGoogle ScholarPubMed
4.Rothman, A. Arterial complications of interventional cardiac catheterization in patients with congenital heart disease. Circulation 1990; 82: 1868–1871.CrossRefGoogle ScholarPubMed
5.Cassidy, SC, Schmidt, KG, van Hare, GF, Stanger, P, Teitel, DF. Complications of pediatric cardiac catheterization: a 3-year study. J Am Coll Cardiol 1992; 19: 1285–1293.CrossRefGoogle Scholar
6.Benson, LN, Nykanen, D. Interventional pediatric cardiology: An overview. In: Beyar, R, Keren, G, Leon, MB, Serruys, PW (eds). Frontiers in interventional cardiology. Martin Dunitz, London, 1997, pp 409–423.Google Scholar
7.Zeevi, B, Berant, M, Blieden, LC. Lare death ftom aneurysm rupture following balloon angioplasty for branch pulmonary artery stenosis. Cath Cardiovasc Diagn 1996; 39: 284–286.3.0.CO;2-F>CrossRefGoogle Scholar
8.Yu, LC, Greene, G, Sperling, D, Morgan, BC. Infective endocarditis following cardiac catheterization in infancy: a case report and review. Clin Pediatr (Phila) 1986; 25; 222–224.CrossRefGoogle ScholarPubMed
9.Cujec, B, McMeekin, J, Lopez, J. Bacterial endocarditis after per- cutaneous aortic valvuloplasty. Am Heart J 1988; 115: 178–179.CrossRefGoogle Scholar
10.Kalra, GS, Wander, GS, Anand, IS. Right sided endocarditis after balloon dilation of the pulmonary valve. Br Heart J 1990; 63: 368–369.CrossRefGoogle ScholarPubMed
11.Sanyal, SK, Wilson, N, Twum-Danso, K, Abomelha, A, Sohel, S. Moraxella endocarditis following balloon angioplasty of aortic coarctation. Am Heart J 1990; 119: 1421–1423.CrossRefGoogle ScholarPubMed
12.Rocchini, AP, Beekman, RH, Ben Sachar, G, Benson, LN, Scwartz, D, Kan, JS. Balloon aortic valvuloplasty: results of the valvuloplasty and angioplasty of congenital anomalies registry. Am J Cardiol 1990; 65: 784–789.CrossRefGoogle ScholarPubMed
13.Tynan, M, Finley, JP, Fontes, V, Hess, J, Kan, JS. Balloon angioplasty for the treatment of native coarctation. Results of valvuloplasty and angioplasty of congenital anomalies registry. Am J Cardiol 1990; 65: 790–792.CrossRefGoogle ScholarPubMed
14.Hellenbrand, WS, Allen, MD, Golinko, RJ, Hagler, M, Lutin, W, Kan, JS. Balloon angioplasty for aortic recoarctation: results of the valvuloplasty and angioplasty of congenital anomalies registry. Am J Cardiol 1990; 65: 793–797.CrossRefGoogle ScholarPubMed
15.Ino, T, Benson, LN, Freedom, RM, Barker, GA, Zipursky, A, Rowe, RD. Thrombolytic therapy for fenoral artery thrombosis following pediatric cardiac catheterization. Am Heart J 1988; 115: 633–639.CrossRefGoogle Scholar
16.Brus, F, Witsenburg, M, Hofhuis, WJD, Hazelzet, JA, Hess, J. Streptokinase treatment for femoral artery thrombosis after arterial cardiac catheterization in infants and children. Br Heart J 1990; 63: 291–294.CrossRefGoogle ScholarPubMed
17.Sacks, D, Robinson, ML, Perlmutter, GS. Femoral arterial injury following catheterization: Duplex evaluation. J Ultrasound Med 1989; 8: 241–246.CrossRefGoogle ScholarPubMed
18.Senzaki, H, Koike, K, Isoda, T, Ishizawa, A, Hishi, T, Yanagisawa, M. Use of the internal jugular vein approach in balloon dilatation angioplasty of pulmonary artery stenosis in children. Pediatr Cardiol 1996; 17: 82–85.CrossRefGoogle ScholarPubMed
19.Celermajer, DS, Robinson, JTC, Taylor, JFN. Vascular access in previously catheterised children and adolescents: a prospective study of 131 consecutive cases. Br Heart J 1993; 70: 554–557.CrossRefGoogle ScholarPubMed
20.Gentles, TL, Lock, JE, Perry, SB. High pressure balloon angioplasty for branch pulmonary artery stenosis: early experience. J Am Coll Cardiol 1993; 22: 867–872.CrossRefGoogle ScholarPubMed
21.Steinberg, C, Levin, AR, Engle, MA. Transient complete heart block following percutaneous balloon pulmonary valvuloplasty: treatment with systemic corticosteroids. Pediatr Cardiol 1992; 13: 181–183.CrossRefGoogle ScholarPubMed
22.Lo, RNS, Lau, KC, Leung, MRComplete heart block after balloon dilatation for congenital pulmonary stenosis. Br Heart J 1988; 59: 384–386.CrossRefGoogle ScholarPubMed
23.Thomsen, NH, Horslev-Petersen, K, Simonsen, EE. Complete heart block in Reiter's syndrome. Dan Med Bull 1985; 32: 272–273.Google ScholarPubMed
24.Dall, JLC. The effect of steroid therapy on normal and abnormal atrio-ventricular conduction. Br Heart J 1964; 26: 537–543.CrossRefGoogle Scholar
25.Allen, HD, Beekman, RH, Garson, A, Hijazi, ZM, Mullins, C, O'Laughlin, MP, Taubert, KA. Pediatric therapeutic cardiac catheterization. A statement for healthcare professionals from the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 1998; 97: 609–625.CrossRefGoogle Scholar